Every day I experience life in the world of healthcare IT, supporting 3000 doctors, 18000 faculty, and 3 million patients. In this blog I record my experiences with infrastructure, applications, policies, management, and governance as well as muse on such topics such as reducing our carbon footprint, standardizing data in healthcare, and living life to its fullest.

Wednesday, October 5, 2011

The Responsibility of Formal Authority

You probably expected me to write about the new iPhone 4S today, but the press has analyzed it well, especially Computerworld. Next week I will write about the impact of accelerated consumer IT product releases on CIOs, including managing customer expectations for business IT innovation.

In the meantime, a few thoughts on the wise use of formal authority i.e. that job description we were handed when we first became CIOs.

In previous blog posts I've reflected on the fact that none us of really have authority. Instead, we have responsibility and risk.

The work that I do in all my lives - Federal, State, BIDMC, Harvard Medical School, and my home life as father/husband/son - do not rely on formal authority. They rely on my informal authority to inspire, align, and communicate.

I have never "ordered" a change. The best I can do is to facilitate consensus and follow Harvard Business School Professor John Kotter's principles for change management:

Relationship building and fostering trust bring me the informal authority I need to lead people through change.

Although the formal authority I have is never used, there are behavioral responsibilities that come with the title CIO. I have to be careful what I say, who I speak with, and what I do, because the hierarchy of the organization assigns power relationships to the role I serve. There are five guidelines I've assigned myself:

1. Respect hierarchical boundaries - if I bypass my direct reports and communicate directly with their direct reports, I always ensure the communication includes everyone in the chain of command. If I did not do this, I would disempower my managers and directors.

2. Communicate consistently with everyone - it's bad behavior is to tell different versions of the truth to people based on what you believe various audiences want to hear. By communicating consistently, I create a culture of collaboration. The last thing I want to do is create discord in the organization by encouraging people to work against each other or foster dissension among teams.

3. Work via standard processes - it may seem expedient to invent your own processes, bypass hierarchies, or work around established lines of communication in an effort to accelerate projects. My experience is that such an approach causes confusion, misalignment of priorities, and wasted effort. Just as I respect hierarchical boundaries, I follow standard processes when problems need to be resolved.

4. Communicate broadly and honestly - if there is problem in the organization, I communicate it to all stakeholders. It is far better to over communicate, even if the news is challenging/difficult, than to work in silos and try to hide failures for fear of embarrassment.

5. Work openly and transparently - we've all worked in organizations with office politics that happen behind the scenes. Back channel conversations, blind cc's on email, escalation around hierarchical boundaries, different conversations in the open verses behind closed doors, and undermining the authority of others can occur in any organization. If someone suggests solving a problem by working on it clandestinely, I refuse. Problems should be solved openly and transparently with all the stakeholders in the room.

These are the responsibilities of formal authority. Although you may never use the power you've been given in your job description, your actions every day can impact your peers and your staff in subtle ways. Once you understand that your every word and behavior can inspire, influence, or irritate, you'll have mastered the responsibility of formal authority.

1 comment:

John - I was a little late getting to this post but am glad to have read. In many healthcare organizations there are those employed directly by the organization and then there are those with whom an affiliated relationship exists to the primary or parent organization. Have you experience with Professor Kotter's principles for change management working equally between parent and affiliated organizations?